Niki--
Is the pain causing you not to sleep or is it insomnia from another cause ?

If you are unsure, keep a diary or journal with your activities, pain levels etc-- especially at night.

If the pain is causing you not to sleep, my thought is you need to get better pain control. All the OTC and even some of the meds that make you drowsy aren't going to help if it is the pain that is keeping you awake.

My other concern, is the amount and different types of meds that you are using to try to help you sleep, all at once.

Ativan, as you probably know, is in a class of medications known as Benzodiazapines (sp ?)--- they slow down the brain and nervous system, hence why the help with seizures, anxiety, etc; BUT, it won't necessarily put you to sleep. I take ativan when I have cluster seizures-- it stops the seizures and is very sedating and I sleep for several hours (depending on the dose), but normally I dont sleep for more than several hours. In otherwords, it is NOT a med normally used soley for sleep.

Benedryl is an antihistamine-- it can make you sleepy, but it doesn't "cause" sleep.

I don't know what is in your PM med, but most of them usually contains the active ingredient in Benedryl or Melatonin. I've tried Melatonin -- a natural med and it does nothing for me.

My point is, all of those put together could cause a dangerous interaction and some weird reactions/side effects.

I know you are frustrated--- I get very frustrated from lack of sleep too. If I am having an RSD flare, my sleep is effected; if I am having an Interstitial Cystitis flare--- where I have to get up 5 times a night to go to the bathroom, my sleep is effected; when my seizures are clustering I may "sleep" by its a very interupted, non restful sleep. I am lucky if I get 5 hours a night.

My best advice is to speak to your doctor and explain to him/her HOW the lack of sleep is effecting your every day life. (For instance, when I get less than 5 hours of sleep, I start having an increase in seizures which can set off other problems.... ) Talk to the doctor who seems to be most receptive and whom deals with the issue that is causing the lack of sleep. I have found that when they see how the insomnia/sleep/pain is effecting your life, they tend to be more receptive and open to finding a soloution.

Hang in there !

L2L